ENDOCRINOLOGY OF PREGNANCY: Gestational diabetes mellitus: definition, aetiological and clinical aspects.
نویسندگان
چکیده
Gestational diabetes (GDM) is defined as a glucose intolerance resulting in hyperglycaemia of variable severity with onset during pregnancy. This review aims to revisit the pathogenesis and aetiology of GDM in order to better understand its clinical presentation and outcomes. During normal pregnancy, insulin sensitivity declines with advancing gestation. These modifications are due to placental factors, progesterone and estrogen. In a physiological situation, a compensatory increase in insulin secretion maintains a normal glucose homeostasis. GDM occurs if pancreatic β-cells are unable to face the increased insulin demand during pregnancy. GDM is most commonly a forerunner of type 2 diabetes (T2D) - the most prevalent form of diabetes. These women share similar characteristics with predisposed subjects to T2D: insulin resistance before and after pregnancy, and carry more T2D risk alleles. Auto-immune and monogenic diabetes are more rare aetiologies of GDM. Adverse pregnancy outcomes of GDM are mainly related to macrosomia caused by fetal hyperinsulinism in response to high glucose levels coming from maternal hyperglycaemia. Screening recommendations and diagnosis criteria of GDM have been recently updated. High risk patients should be screened as early as possible using fasting plasma glucose, and if normal, at 24-28 weeks of gestation using 75 g oral glucose tolerance test. The treatment of GDM is based on education with trained nurses and dieticians, and if necessary insulin therapy.
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Background and Objective: Diabetes Mellitus is a metabolic disease and the most prevalent disorder in pregnancy. Gestational diabetes mellitus is a kind of diabetes that is recognized in pregnancy. Many risk factors have been recognized for gestational diabetes mellitus. Determining new risk factors help to identify women who are at risk for diabetes. This research was conducted in order to det...
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Background: Gestational diabetes is defined as carbohydrate intolerance of variable severity with onset or first recognition during pregnancy. Approximately 4% of pregnancies are affected by diabetes mellitus, 90% of which represent gestational diabetes mellitus (GDM). Detection of GDM permits the identification of women who are at risk for development of type 2 diabetes mellitus later in life....
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عنوان ژورنال:
- European journal of endocrinology
دوره 174 2 شماره
صفحات -
تاریخ انتشار 2016